Massachusetts (LLC) Limited Liability Company Form

To form a LLC in the State of Massachusetts download and submit this form to the Secretary of State office in Massachusetts along with a filing fee of $500.

Address of Secretary of State, Massachusetts

Secretary of the Commonwealth

One Ashburton Place,
Room 1717,
Boston,
Massachusetts 02108-1512

Massachusetts (LLC) Limited Liability Company Form

Text Version of the Form

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D The Commonwealth of Massachusetts
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512

Limited Liability Company
Certificate of Organization
(General Laws Chapter 156C, Section 12)

Federal Identification No.: _____________________________

(1) The exact name of the limited liability company:

________________________________________________________________________________________________

(2) The street address of the office in the commonwealth at which its records will be maintained:

(3) The general character of the business:

(4) Latest date of dissolution, if specified: ___________________________________________________________________

(5) The name and street address, of the resident agent in the commonwealth:

NAME ADDRESS

(6) The name and business address, if different from office location, of each manager, if any:

NAME ADDRESS

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(7) The name and business address, if different from office location, of each person in addition to manager(s) authorized to
execute documents filed with the Corporations Division, and at least one person shall be named if there are no managers:

NAME ADDRESS

(8) The name and business address, if different from office location, of each person authorized to execute, acknowledge, deliver
and record any recordable instrument purporting to affect an interest in real property recorded with a registry of deeds or
district office of the land court:

NAME ADDRESS

(9) Additional matters:

Signed by (by at least one authorized signatory): ________________________________________________________________

Consent of resident agent:

I __________________________________________________________________________________________________ ,
resident agent of the above limited liability company, consent to my appointment as resident agent pursuant to G.L. c 156C § 12*

*or attach resident agent’s consent hereto.

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COMMONWEALTH OF MASSACHUSETTS

William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512

Limited Liability Company Certificate
(General Laws Chapter 156C, Section 12)

I hereby certify that upon examination of this limited liability company certificate,
duly submitted to me, it appears that the provisions of the General Laws relative
thereto have been complied with, and I hereby approve said application; and the
filing fee in the amount of $ _______ having been paid, said application is deemed
to have been filed with me this
________________ day of ________________ , 20 _____ , at _______a.m./p.m.
time

Effective date:_____________________________________________________

WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth

Filing fee: $500

TO BE FILLED IN BY LIMITED LIABILITY COMPANY
Contact Information:

___________________________________________________________

___________________________________________________________

___________________________________________________________

Telephone: ___________________________________________________

Email: ______________________________________________________

Upon filing, a copy of this filing will be available at www.sec.state.ma.us/cor.
If the document is rejected, a copy of the rejection sheet and rejected document will
be available in the rejected queue.

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